ObjectiveTo investigate the relationship between serum 25(OH)D and gestational diabetes mellitus in the second trimester (GDM), to analyze the interaction effect of key risk factors, so as to provide a basis for clinical personalized vitamin D supplementation. MethodsA total of 266 pregnant women who registered and took regular obstetric check-ups in Shanghai Pudong New Area Health Care Hospital for Women and Children from June to December 2022, were selected as the research subjects. According to the results of oral glucose tolerance test (OGTT), the subjects were divided into the GDM group (131) and control group (135). The level of serum 25(OH)D at the time of OGTT were detected and other clinical indicators were followed up. ResultsThe age, systolic blood pressure in early pregnancy, pre-pregnancy BMI, FPG, OGTT 1-hour and 2-hour glucose, GHb, HOMA-IR, TG, AST, Cr, D-D, FDP and SF at 35 weeks’ gestation of the pregnant women were higher in the GDM group than that of the pregnant women in the normal group, while gestational weight gain and serum 25(OH)D level were significantly lower than that of the pregnant women in the normal group. Serum 25(OH)D was negatively correlated with HOMA-IR and WBS’s, but positively correlated with TG and ALT. Serum 25(OH)D was non-linearly correlated with the risk of GDM in an inverted J-shape, and there was an interaction effect of advanced age, pre-pregnancy obesity and vitamin D deficiency on the risk of GDM. ConclusionVitamin D is non-linearly associated with the risk of GDM. The risk of GDM is significantly reduced when serum 25(OH)D level ≥30 ng∙mL^-1.

Objective:To develop the Nutrition Impact Symptom Scale for Colorectal Cancer Patients.Methods:Guided by the theory of unpleasant symptoms, the initial draft of the scale was formed through literature research, expert consultation, and small sample pre-survey. From March to May 2023, convenience sampling was used to select 127 colorectal cancer patients who visited Jiangsu Cancer Hospital as the research subject for item analysis and reliability and validity testing of the scale.Results:The final scale consisted of five dimensions and a total of 17 items. The content validity index of the scale was from 0.83 to 1.00, with an average content validity index of 0.97. Exploratory factor analysis extracted five common factors, and the cumulative variance contribution rate was 61.622%. The total Cronbach's α coefficient of the scale was 0.708, and the coefficients for each dimension were 0.762, 0.642, 0.625, 0.510, and 0.644, respectively. The half reliability coefficient of the scale was 0.824.Conclusions:The development process of the Nutrition Impact Symptom Scale for Colorectal Cancer Patients is scientific, with good reliability and validity, and can be used to evaluate the nutrition impact symptom of colorectal cancer patients.

Objective:To systematically evaluate the medication experience and needs of patients with oral anticancer drugs at home, providing reference for the formulation and implementation of home supervision measures for these patients.Methods:PubMed, Embase, Web of Science, The Cochrane Library, CINAHL, CNKI, Wanfang database, VIP database and Chinese biomedical literature database were searched by computer to collect qualitative studies on medication experience and needs of patients with oral anticancer drugs at home. The retrieval period was from the database construction to May 1, 2021. The quality of the literature was evaluated by the Australian JBI qualitative research quality evaluation criteria for evidence-based health care centres, and the results were integrated by the pooled integration method of Meta-integration.Results:A total of 11 studies were included, 52 results were extracted, 13 categories were summarized and 4 integrated results were obtained: heavy negative psychological experience; undergo physical trials; a desire for outside support; adjust to the disease.Conclusions:According to the four aspects of experience and needs of patients with oral anticancer drugs at home, medical staff should guide them to establish health belief, improve disease perception and coping ability, and take measures to meet patients′ needs for knowledge, communication and social support through multiple channels.

Objective:To explore the inner experience of self-management of adverse drug reactions in patients with oral chemotherapy at home, so as to provide a basis for medical staff to better implement home supervision of patients.Methods:This study was a qualitative study. The purposive sampling method was used to select 12 patients with gastrointestinal tumors who were admitted to Department of Oncology of a ClassⅢ Grade A hospital in Nanjing from April to May 2021 and were required to take oral chemotherapy drugs at home for semi-structured in-depth interviews. Colaizzi's 7-step analysis method was used to analyze and summarize the interview data.Results:A total of 3 themes and 7 sub-themes were extracted from the inner experience of self-management of adverse drug reactions in patients with oral chemotherapy at home. Theme one was the perception of self-management of adverse drug reactions in patients undergoing oral chemotherapy at home. This included anxiety and fear in the face of adverse reactions and ambivalence in seeking to communicate with medical staff. The topic two was the attitude and behavior of self-management of adverse drug reactions in patients with home-based oral chemotherapy drugs. This included insufficient attention to active review of adverse effects of myelosuppression and a lack of ability to identify adverse drug reactions. The topic three was the motivation and needs of self-management of adverse drug reactions in patients with home-based oral chemotherapy. The family's careful care provided strong support, the convenience of mobile communication relieved the patient's troubles and there was a need for information and knowledge of the adverse reactions of oral chemotherapy drugs.Conclusions:Medical staff need to strengthen drug knowledge education and psychological care for gastrointestinal tumor patients taking oral chemotherapy drugs at home and build a mobile information platform to improve their self-management capabilities.

Objective:To explore the real experience of developing self-consciousness, self-discovery, self-identity crisis and self-cognition improvement of young cancer patients from the initial stage of diagnosis, and to provide reference for medical staff to construct the intervention mode of psychosocial support.Methods:Using phenomenological method in qualitative research, 14 young cancer patients aged 18-25 years from April 2019 to August 2020 in Jiangsu Cancer Hospital were interviewed in semi-structured way separately at three time points: initial diagnosis, 6 months after diagnosis and 12 months after diagnosis. 7-step Colaizzi analysis was used to analyze the data.Results:Three themes were extracted as following. The dilemma of self-cognition, self-identity biases and the exploration of self-identity.Conclusions:Attention should be paid to the psychological problems of young cancer patients at all stages, and meet the needs of patients to talk, cooperate with professional psychotherapists, encourage patients to recognize themselves, tap the inner positive power, so as to improve their sense of self-identity.

Objective:To explore the experience of young cancer patients using mobile health applications, so as to provide a basis for improving the utilization rate and sustainability of health applications.Methods:From May to June 2020, purpose sampling was used to select 12 young cancer patients in the Internal Medicine Ward of a ClassⅢ Grade A cancer hospital in Nanjing, Jiangsu Province. The semi-structured interview with patients was conducted with the descriptive phenomenological method. The Colaizzi 7-step analysis method was used to analyze the data and refine the theme.Results:A total of four themes were summarized, namely, there was a difference in usage attitudes (being used for rehabilitation management, as a means of verification, generating resistance, and reducing the frequency of use) , insufficient function development and reduced user experience (lack of autonomy, insufficient intelligent evaluation) , desiring a professional operating agency, recognizing the development prospects and looking forward to perfection.Conclusions:In follow-up studies, researchers need to fully consider the patient's preference and usage habits for health applications on the basis of meeting the needs of disease management.

Objective To explore and understand the influence of perceived professional benefits on oncology nurses′innovative behaviors. Methods Totally 943oncology nurses were selected to join thestudy, Using the general information questionnaire, nurses′ perceived professional benefits scale and innovative behaviors scale for investigation. Results The average score of oncology nurses′ perceived Professional Benefits Scale was (114.08 ± 16.45) points, the average score of oncology nurses′ innovative behaviors was (31.00 ± 7.00) points. The score of perceived professional benefits of oncology nurses was positively correlated with score of innovative behavior of nurses (r=0.472, P<0.01). Nurses position, level and relatives and friends identity,their own growth and team belonging in perceived professional benefits were the influencing factors of innovative behavior of oncology nurses (t=2.022-4.486, P<0.05 or 0.01). Conclusion The perceived professional benefits of oncology nurses can play a positive role in promoting their innovative behaviors. Nursing managers should pay attention to improving perceived professional benefits of clinical nurses, promote their innovative behaviors and improve the quality of nursing services.

Objective: To investigate the effects and the underlying mechanism of DS2, a newly synthetic analog of natural ent-kaurane diterpenoid, on the proliferation and migration capabilities of human gastric cancer cells. Methods: MTT assay, colony formation assay and flow cytometry were used to measure the effects of DS2 on growth, apoptosis and cell cycle of several human gastric cancer cell lines. The function of DS2 in the migration was further detected by wound healing and transwell assays. The expression of migration related proteins were determined by western blot. Results: DS2 inhibited the growth of MGC-803, SGC-7901 and HGC-27 cells in a dose dependent manner. After treatment of DS2 at a concentration of 6.25 μmol/L for 24 h, the survival rates of MGC-803, SGC-7901 and HGC-27 cells were 53.87±3.05%, 55.91±6.97% and 32.41±2.64%, respectively. However, for the normal gastric epithelial cell GES-1, no obvious growth inhibition was observed. In addition, DS2 caused significant G₂/M arrest and induced apoptosis in MGC-803 cells. Furthermore, compared with the negative control, the colony formation, wound healing rate as well as the number of migrating cells of MGC-803 were significantly decreased in a dose dependent manner after DS2 treatment. DS2 induced the expression of E-cadherin, whereas β-catenin and N-cadherin levels were downregulated in MGC-803. Conclusion The new compound DS2 has a strong anti-cancer activity, and this study will help us to design and synthesize better diterpenoids derivatives.

Objective To deeply understand the risk factors of lymphedema for patients with breast cancer after surgery. Methods The phenomenological method was applied in this study. Semi-structured interview was used to collected data from 9 female breast cancer patients with lymphedema after surgery in our hospital from June to September 2016 for generic analysis. Results The risk factors of lymphedema could be categorized into four themes:(1)choice of treatment is the primary cause:axillary lymph node dissection; radiotherapy; chemotherapy; (2)not paying enough attention to lymphedema:lacking the knowledge of lymphedema; imbalance of physical activities for the affected limb; lacking awareness of exercise and protection of the affected limb. Conclusions Axillary lymph node dissection after radical surgery for patients with breast cancer is the primary cause of lymphedema, and paying not enough attention is an important factor, especially lacking the consciousness of prevention, so the nurses should emphasize education about prevention of lymphedema after surgery for patients, to improve the consciousness of them to reduce the occurrence of lymphedema and its influence on their quality of life.

Objective:To investigate the diagnostic value of different detection methods for Mycobacterium tuberculosis in bronchoalveolar lavage fluid (BALF) from patients with pulmonary tuberculosis.Methods:BALF from l00 patients in Changsha Central Hospital from January 2013 to December 2015 was collected.Among 100 patients,65 cases were clinically diagnosed as tuberculosis,and 35 cases served as control.BALF smear method,polymerase chain reaction (PCR) and membrane reverse dot blot (RDB) were used for synchronous detection of Mycobacterium tuberculosis.Results:The positive rates by BALF smear method,PCR and RDB were 43.08％,73.84％ and 92.31％,respectively (P＜0.05).Sensitivity,specificity,accuracy,and negative predictive value for BALF smear were 43.08％,88.57％,59.00％,and 45.59％,respectively;for PCR were 73.85％,100％,83.00％,and 67.31％,respectively;for RDB were 92.31％,100.00％,95.00％,and 87.50％,respectively.Conclusion:The technique of membrane RDB can not only accurately diagnose Mycobacterium tuberculosis,but also can rapidly and easily identify the resistance of Mycobacterium tuberculosis to streptomycin (SM),rifampicin (RFP) and isoniazid (INH) genotypes.It possesses high clinical value.